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Background <p>In-hospital medication changes are a key component of healthcare of older adults. It is important to employ strategies to ensure continuity of changes post-discharge.</p> Objective <p>This systematic review aimed to summarise (i) strategies that have been investigated to facilitate post-discharge continuity of in-hospital medication changes in older adults and (ii) their impact on continuity of medication changes and clinical, health service utilisation and patient-reported outcomes.</p> Methods <p>MEDLINE and EMBASE databases were searched (1946–20/03/2024) to identify strategies that facilitate post-discharge continuity of hospital medication changes and assess their impact on continuity, health service utilisation, and clinical and patient-reported outcomes post-discharge in older adults (mean/median age ≥60 years).</p> Results <p>After screening 800 articles, 49 met inclusion criteria, including 25 quasi-experimental studies, 14 randomised controlled trials, four cohort studies, four observational studies, one case series, and one retrospective case note review and audit. Strategies commonly involved providing discharge medication lists to patients and/or their general practitioners (36/49 studies, 73.5%), discharge counselling (28/49, 57.1%) and medication reconciliation (28/49, 57.1%). Most studies used multi-component strategies (39/49, 79.6%) by multi-disciplinary teams (28/49, 57.1%). Twenty-six of the 36 studies (68.4%) assessing the impact of strategies on continuity reported significant improvements in continuity-related outcomes. Thirteen out of the 21 studies (61.9%) that measured medication discrepancies (most common measure of continuity) reported significant reductions following strategy implementation. One out of 11 studies (9.1%) reported a significant improvement in clinical outcomes, while none of the 13 studies found significant improvements in health service utilisation outcomes. Two of three studies investigating patient-reported quality of life reported significant improvements.</p> Conclusions <p>Strategies focus on communicating medication changes to patients, general practitioners and community pharmacists by multi-disciplinary hospital clinicians. There is evidence of a positive impact of multi-component strategies delivered by a multi-disciplinary team on continuity of medication changes and quality of life post-discharge. Future analyses investigating strategy complexity and cost effectiveness may inform their translation into practice.</p>

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Bridging the Gap: Systematic Review of Strategies to Facilitate Post-Discharge Continuity of In-Hospital Medication Changes in Older Adults

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年2月17日

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  • Kate J. R. Johnstone,
  • Sarah N. Hilmer,
  • Sarita Lo,
  • Lisa Kouladjian O’Donnell,
  • Edwin C. K. Tan,
  • Bonnie Liu,
  • Nashwa Masnoon

摘要

Background

In-hospital medication changes are a key component of healthcare of older adults. It is important to employ strategies to ensure continuity of changes post-discharge.

Objective

This systematic review aimed to summarise (i) strategies that have been investigated to facilitate post-discharge continuity of in-hospital medication changes in older adults and (ii) their impact on continuity of medication changes and clinical, health service utilisation and patient-reported outcomes.

Methods

MEDLINE and EMBASE databases were searched (1946–20/03/2024) to identify strategies that facilitate post-discharge continuity of hospital medication changes and assess their impact on continuity, health service utilisation, and clinical and patient-reported outcomes post-discharge in older adults (mean/median age ≥60 years).

Results

After screening 800 articles, 49 met inclusion criteria, including 25 quasi-experimental studies, 14 randomised controlled trials, four cohort studies, four observational studies, one case series, and one retrospective case note review and audit. Strategies commonly involved providing discharge medication lists to patients and/or their general practitioners (36/49 studies, 73.5%), discharge counselling (28/49, 57.1%) and medication reconciliation (28/49, 57.1%). Most studies used multi-component strategies (39/49, 79.6%) by multi-disciplinary teams (28/49, 57.1%). Twenty-six of the 36 studies (68.4%) assessing the impact of strategies on continuity reported significant improvements in continuity-related outcomes. Thirteen out of the 21 studies (61.9%) that measured medication discrepancies (most common measure of continuity) reported significant reductions following strategy implementation. One out of 11 studies (9.1%) reported a significant improvement in clinical outcomes, while none of the 13 studies found significant improvements in health service utilisation outcomes. Two of three studies investigating patient-reported quality of life reported significant improvements.

Conclusions

Strategies focus on communicating medication changes to patients, general practitioners and community pharmacists by multi-disciplinary hospital clinicians. There is evidence of a positive impact of multi-component strategies delivered by a multi-disciplinary team on continuity of medication changes and quality of life post-discharge. Future analyses investigating strategy complexity and cost effectiveness may inform their translation into practice.